Tips for Finding Home Care

Most people contract with a home care agency for more than one year. They receive services from one hour a day to 24 hours a day. A quality homecare agency becomes their safety net. Do not wait until your loved one’s condition or supportive environment has reached a panic state. Get to know your local homecare options when you begin to notice subtle changes in your loved one’s habits, abilities or behaviors that may be related to age or disease.

  1. Call your state’s elder services office. In Massachusetts, visit the Office of Elder Affairs at http://www.mass.gov/elders or call 1-800-AGE-INFO (1-800-243-4636). Ask them to connect you with your region’s Aging Service Access Provider (ASAP) to schedule a visit by a professional case manager. The case manager will come into your home, physically see you and document your or your loved one’s health and mobility needs. They will discuss your options for home care assistance and help you connect with appropriate services.Know how much you (or the loved one to receive home care) makes every year and whether it is income from working, pension(s), Social Security or any other documented income to the IRS. Be comfortable telling a case manager working for a state agency how much you or the loved one who will receive care makes. Inquire about the benefits you or the loved one are eligible for based on your/their yearly income. The case manager will work with you honestly to determine what your home care options are. You may also call your state’s homecare association or closest town senior center and get their list of home care agencies in your immediate area. In addition, most hospitals’ social service departments and nursing home discharge planners have local lists as well. Ask them if they can recommend at least two or three agencies you can inquire with and investigate. If you live in a rural area, you may have fewer choices.
  • If you are a veteran, the VA has its own home care program.
  • Ask about opening your long-term care contract if you have one.
  1. Call at least two agencies. Three is better to compare how they respond to you and your questions. Ask the following:
  • Does the agency carry worker’s compensation insurance, liability insurance and auto insurance for its workers? Is it licensed by the state or federal government (Medicare and Medicaid)? Is it bonded?
  • Does the agency do a free on-site consultation?
  • Does the Better Business Bureau (BBB) give the agency a good rating? Many agencies are franchises or satellites of national companies and the local owners and management run each one differently. Make sure you have the address of the agency you are directly working with for the BBB.
  • Ask for three references. Call the references and ask them how the agency serves their needs.
  • Some agencies may just want your demographic information. Some may even suggest you pay up front without an interview. Do not do this.

A good agency will want to talk with you about why you are looking for services and what is currently in place now. The agency should have trained and licensed medical professionals on staff who are capable of evaluating home care needs.

A good agency will inquire if there have been any recent medical or physical changes or issues. They will inquire about the current condition of the client and the location and condition of their current residence, whether it’s in the home, hospital, nursing home, hospice etc.

Sometimes an agency will want to know how many family and friends are involved. We suggest the family decides on a spokesperson for the meeting. This is a good opportunity for family members to clarify, understand, and agree on who will be responsible for the different responsibilities in caring for the loved one.

  1. Discuss your loved one’s diagnosis with the intake person you speak with at each agency.
  • Ask if they have had other clients with this disease or condition and if they are familiar with it.
  • Explain your situation to the intake specialist and ask how many aides they have working for them in your area.
  • Ask how long it will take them to see the client and how much time do they need to start services with a new client.
  • Is the agency contracted with any state or federal programs?
  • Does my (or the loved one who requires home care) income make me (or him/her) eligible for services through any state or federal programs)? Can the agency give you a phone number for a referral to such programs?
  • Ask if the agency does a criminal investigation on all of their workers and if they do at least two working reference checks. What credentials must be in place before they hire a worker? Home Care Aides are licensed after 40 – 60 hours of class and hands-on training (e.g., Red Cross license or a school that is known to graduate qualified aides).  Most states license home care agencies, even for private pay.

Ask if a registered nurse will be responsible for your or a loved one’s detailed care plan that takes these things into consideration:

  • Medication management
  • Bathing and personal care
  • Disease management
  • Ambulation
  • Housekeeping, laundry, grocery shopping
  • Eating
  • Transportation
  1. A good agency inquires about each client’s usual activities of daily living: What time do they wake up? What do they like for breakfast? Are they kosher? Do they take an afternoon nap? Do the agency’s care plans manage the home care aide’s routines to help each client maintain their maximum level of physical and mental well-being?
  1. Ask if the agency has 24- hour call service. Do they always have a nurse on call?
  1. Ask about the scheduling system. It should be made available so that clients and their family members know when and who will be arriving to provide care. Clients should sign a time sheet showing the date and the hours of service each day. A time sheet requires the signature of the client, family member, caretaker or another aide after each shift.
  1. Ask detailed questions about the agency’s payment agreement contract and service plan. The plan you sign should spell out the anticipated number of days and hours of service that will be provided per day. The agreement should be signed so the client and/or family member who has Power of Attorney are aware of the charges for all services at all times. A charge for a homemaker two hours a day may be charged at a different rate than a charge for a nurse filling medications once a week. These charges should be defined up front. Also, know how much is charged for transportation services (doing errands, grocery shopping; taking the client to doctor’s appointments, etc.).
  1. Ask the agency if they will provide a different aide if they or their loved one are uncomfortable with the first person assigned.
  • Can you cancel service with the agency at any time?
  • Can you review billed Time Sheets with the agency at any time?
  • Does the agency follow all state and federal privacy laws (HIPPA) to protect client confidentiality?
  • What is your process for reporting cases of worker abuse to the appropriate authorities?
  1. If you are still looking for professional information about home care and hospice, call your local home care association. Home care, more often than not, can be a part of someone’s life for a long time. A good working relationship with your home care agency makes things easier for everyone.

For more tips on disease management and home care, contact Cheryl Rumley RN, President & CEO, Apex Healthcare Services, Inc., Springfield, MA at www.apexcares.com.